Children and teenagers needing psychiatric care are being denied admission to mental health facilities while beds lie idle.
Staff shortages in several dedicated child and adolescent units around the country mean that up to half the beds cannot be made available despite growing waiting lists.
A report by the Inspector of Mental Health Services found waiting times of up to six months for admission, that some patients in Munster were being advised to travel to Dublin for care, and that others were being sent to an adult unit.
It also found that only 12 of the 20 beds in the Éist Linn child and adolescent in-patient unit in Cork were operational.
The report states: “The inspectors were told that this was because there were insufficient multidisciplinary staff to provide for a 20-bed unit. In the meantime, on the day of inspection there were 15 children waiting for admission.”
There was a similar situation at the adolescent in-patient unit at St Vincent’s Hospital, Fairview, Dublin, where only six of 12 beds were available to patients.
At the 39-bed acute psychiatric unit at the Mid-Western Regional Hospital, Ennis, Co Clare, staff reported that it was the norm for bed occupancy to run at 113%.
According to the report: “This meant that residents were frequently required to sleep in inappropriate accommodation. On the day of inspection, one resident’s bed was located on a corridor space with no provision for safe storage of personal belongings or privacy, and another resident was rummaging through these personal belongings.”
The inspector also found that overcrowding was leading to children being transferring to the adult psychiatric unit at Limerick Regional Hospital, a practice described as “not in the best interest of the residents”.
Because there is no dedicated unit in Limerick, those referred by the child and adolescent mental health services team there were waiting on average three months to get a bed elsewhere. At the time of inspection, two children had been waiting six months.
That was also an issue for the team in Waterford which had to source beds in Cork and encountered long delays as a result.
The inspector found: “It was stated that often, advice was given to obtain a private bed in St John of God Hospital or St Patrick’s University Hospital in Dublin.”
There was concern over access to emergency care, with the inspectors told of a seriously ill 15-year-old being kept in the emergency department of Waterford Regional Hospital for three days because there was no in-patient bed available. The only alternative would have been to admit the child to an adult unit.
Bed shortages were also a problem for the South Kildare Child and Adolescent Mental Health Service, which used the Linn Dara Centre in Dublin but had 47 children on its waiting list.
Where children could access care, it was generally found to be of a good standard across the 27 centres, units, and day services inspected.
However, the inspector did find occasional breaches of regulations, including one where electric shock therapy was given to a patient without consent and another where there was lack of paperwork to explain why a child had been subjected to an intimate search.
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